The experiences gained from 94 patients who were operated upon by various procedures for carotid artery stenosis or complete occlusion are presented and discussed. Fifty-five patients had endarterectomy for carotid stenosis and follow-up averaged 3 1/2 years. Post-operative angiography is important in evaluating the results, for occlusion can occur silently without neurologic deficit. In some cases of complete carotid occlusion, it has been possible to re-establish blood flow as late as 3 1/2 weeks after onset of hemiparesis. There was little evidence that vascular surgery benefits the neurologic function of patients with completed stroke, no matter how recent The best results are obtained when there are few symptoms or signs. The procedure of endarterectomy in many cases is a preventive from later serious and dire results of occlusion or forward embolism. It is prophylactic toward preventing cerebral infarction and neurologic deficit from carotid stenosis due to atherosclerosis. Carotid endarterectomy does not prevent cerebral infarction from causes other than carotid stenosis, but appears to reduce recurrent attacks of cerebral vascular ischemia due to carotid stenosis.